Patient had previously been in surgery for prolapsed rectum. Age and long term steroid use are co-morbidities. Patient was taken back into surgery when mid portion of wound opened, shoing extruded small bowel, which had been covered by Wound VAC. Staples had not held with a complete separation of stitches from right side of rectus anterior fasica. Following is direct quote from surg report:
"A FlexHD mesh was chosen for the size of the orifice. A 6 X 16 cm and the corners were cutoff to allow for placement in a nontension type of closure. Each side was then sutured with a running continuous stitch of 2-0 Prolene incorporating the anterior rectus fascia with the edge of the FlexHD mesh. Once the entire construct had been closed, the area was again irrigated copiously and a wound VAC was placed with white foam against the FlexHD and then black foam to fill the rest of the abdominal wall to the edge of the skin."

Any suggetions?